SHANNON SULLIVAN SMITHSON (NPI# 1154603264) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154603264 |
| Entity Type | Individual |
| Full Name | SHANNON SULLIVAN SMITHSON |
| Credential | PA-C |
| Practice Address |
1513 Fremont Blvd Ste E1 Seaside CA 93955-4319 |
| Practice Telephone | 8318991910 |
| Practice Fax Number | 8313939483 |
| Mailing Telephone | 8318991910 |
| Mailing Fax Number | 8313939483 |
| Enumeration Date | 2011-09-14 |
| Last Update Date | 2019-04-30 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 21852 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1000 Brabham Ave, Jacksonville, NC 285465003 | 9103413300 | 9102512067 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700032638 | Shannon Smithson | Specialist/Technologist, Other | 312 21st Ave N, Nashville, TN 37203-1846 | 2008-08-12 |
| Street Address |
1513 FREMONT BLVD STE E1 |
| City | SEASIDE |
| State | CA |
| Zip Code | 93955-4319 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912472614 | Benbenedic Montoya Aquino | Registered Nurse | 2095, 2095 Paralta Avenue, Seaside, CA 93955 | 2018-10-09 |
| 1316435803 | Teddy Yaw Akosa Agyapong | Pharmacist | 1055 Fremont Bld, Seaside, CA 93955 | 2018-04-30 |
| 1700381423 | Edmundo Fimbres Od Inc | Optometrist | 915 Hilby Ave Ste 1, Seaside, CA 93955 | 2018-03-26 |
| 1275948671 | Brian Peter Farley | Marriage & Family Therapist | 1187 Broadway Ave, Seaside, CA 93955 | 2014-06-24 |
| 1689953044 | Vertis Nathaniel Elmore IIi | Marriage & Family Therapist | 1069 Broadway Ave., Suite 201, Seaside, CA 93955 | 2011-08-16 |
| 1598944993 | Mary Theresa Panlilio | Dentist | 1249 Fremont Blvd, Suite B, Seaside, CA 93955 | 2007-11-01 |
| 1346459641 | Caroline Thomas Haskell | Social Worker | 100 Campus Center, Bldg 80, Seaside, CA 93955 | 2007-05-22 |
| 1811014715 | Anita Gor | Optometrist | 2040 California Ave. Target, Target Optical, Sand City, CA 93955 | 2007-03-23 |
| 1942333059 | Central Coast Pediatric Dental Group | Dentist | 1717 Fremont Blvd, Seaside, CA 93955 | 2007-03-14 |
| 1831209436 | Costco Wholesale Corporation | Pharmacy | 801 Tioga Ave, Sand City, CA 93955 | 2006-08-30 |
| Find all providers in zip 93955 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902264559 | Zachary Caverley | Physician Assistant | 725 S Wahanna Rd, Seaside, OR 97138-7735 | 2016-02-10 |
| 1326477423 | Jennifer Bartley | Physician Assistant | 100 Campus Ctr, Bldg. 80, Seaside, CA 93955-8000 | 2013-11-08 |
| 1083704142 | Mary Susan Schonfield | Physician Assistant | 625 Hilby Ave, Seaside, CA 93955-5720 | 2006-10-12 |
| 1669432662 | Michael J Forrest | Physician Assistant | 725 S Wahanna Rd, Seaside, OR 97138-7735 | 2006-03-24 |
| 1639156854 | Daniel J Sitkowski | Physician Assistant | 725 S Wahanna Rd, Seaside, OR 97138-7735 | 2005-12-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902407679 | Samantha Sidney Spinner | Physician Assistant | 1385 Shattuck Ave Apt 201, Berkeley, CA 94709-1468 | 2020-11-08 |
| 1134720972 | Alessandra Porfido | Physician Assistant | 733 Filbert St Apt 1, San Francisco, CA 94133-2767 | 2020-11-06 |
| 1992306872 | Kelsey Oberg | Physician Assistant | 1817 Oldfield Ct, El Cajon, CA 92019-4233 | 2020-11-05 |
| 1609477504 | Julia Claire Stiefel | Physician Assistant | 369 Orange St Apt A, Oakland, CA 94610-2979 | 2020-11-05 |
| 1164023347 | Wendy P Lewis | Physician Assistant | 10447 Highdale St, Bellflower, CA 90706-4122 | 2020-11-04 |
| 1245830181 | Lauren Bennett | Physician Assistant | 3360 Horizon St, Corona, CA 92881-0728 | 2020-10-29 |
| 1538769062 | Revital Ahl | Physician Assistant | 18141 Medley Dr, Encino, CA 91316-4447 | 2020-10-26 |
| 1922607423 | Emily Halla | Physician Assistant | 7473 Gresham Ct, San Jose, CA 95139-1424 | 2020-10-26 |
| 1386243889 | Ilaitia Lecia Namatasere | Physician Assistant | 614 Sycamore Ln Apt 225, Davis, CA 95616-7901 | 2020-10-26 |
| 1083213706 | Courtney Kathryn Hopp | Physician Assistant | 4060 Fourth Ave Ste 209, San Diego, CA 92103-2120 | 2020-10-23 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on SHANNON SULLIVAN SMITHSON.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.